乳腺肿块良恶性诊断中使用超声弹性成像的临床研究

Clinical study on the use of ultrasound elastography in the diagnosis of benign and malignant breast masses

目的探讨乳腺肿块良恶性诊断中使用超声弹性成像的临床研究。方法选取我院接受乳腺肿块切除的住院病人,收集时间为2008年2月至2014年8月,共计350例,平均年龄(36.2±23.3)岁,中位年龄44.5岁,乳腺病灶共350个,患者在接受乳腺肿块切除前均行二维B超及超声弹性检查,350个病个均经手术后病理切片证实,其中良性病个170个,恶性病个180个,分别定义为良性组,恶性组。对所有乳腺病灶进行弹性成像打分,并且与最终的病理诊断进行对比。结果良性组170个结节,其中63个乳腺病,57个纤维腺瘤,17个乳腺炎,13个导管内乳头状瘤,6个纤维脂肪瘤,5个硬化性腺病、5个血管脂肪瘤,4个黏液腺瘤。恶性组中:160个浸润性导管癌,6个浸润性小叶癌,5个叶状囊肉瘤,3个湿疹样癌,黏液腺癌2个,1个乳头样癌,1个原位癌,1个髓样癌,1个高度糖原透明癌。170例良性结节平均得分为1.76±0.65,180例;恶性结节平均得分为4.3±1.21,良性结节平均得分与恶性结节平均得分差异有统计学意义(P<0.05)。恶性组诊断准确率为96.7%,良性组诊断准确率为96.2%,恶性组诊断准确率与良性组诊断准确率作为差异无统计学意义(P>0.05)。结论超声弹性成像能准确的区分良恶性乳腺肿块,对临床诊断乳腺肿块性质提供了新的无创手段。

Objective To investigate the clinical study on the use of ultrasound elastography in the diagnosis of benign and malignant breast masses.Methods In our hospital inpatients with resection of breast masses, collect in time for the 2008 February to2014 August, a total of 350 patients, mean age（36.2 ± 23.3） years old, median age 44.5 years, a total of 350 breast lesions, patients receiving breast tumor resection were performed in 2D B ultrasound and ultrasonic elastography, 350 disease a were confirmed by operation and pathology slice after confirmed, the benign disease and 170 malignant disease, 180, are defined as benign,malignant group. Elastography score of all breast lesions, and were compared with the pathological diagnosis of the final.Results Benign group 170 nodules, including 63 breast disease, 57 fibroadenoma, 17 mastitis, 13 intraductal papilloma, 6 fiber lipoma, 5sclerosing adenosis, 5 angiomyolipomas, 4 mucinous adenoma. In the malignant group： 160 infiltrating ductal carcinoma, 6 infiltrat-ing lobular carcinoma, 5 cystosarcoma phyllodes, 3 eczematoid carcinoma, mucinous adenocarcinoma 2, 1 papillary carcinoma, 1carcinoma in situ, 1 medullary carcinomas, 1 highly glycogen transparent cancer. 170 cases of benign nodules. The average score was 1.76 ± 0.65, 180 cases of malignant nodules; the average score was 4.3 ± 1.21, the average score was statistically significant benign nodules and malignant nodules of the difference in mean score（P0.05）. The accurate rate of diagnosis of malignant group was 96.7%, the accuracy rate of diagnosis of benign group was 96.2%, the accuracy rate of diagnosis in malignant group and benign group diagnosis accurate rate as the difference was not statistically significant（P 0.05）.Conclusion Ultrasound elasticity imaging can accurately differentiate between benign and malignant breast tumors, the clinical diagnosis of breast masses provides a noninvasive means new.